| NPI | 1275921579 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX PA09559) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX PA09559) |
| 208000000X Pediatrics (Licence: TX PA09559) | |
| 363A00000X Physician Assistant (Licence: TX PA09559) | |
| Enumeration Date | 2015-01-08 |
| Last Update Date | 2019-11-07 |